无水酒精固化卵巢巧克力囊肿联合改良超长方案用于子宫内膜异位症的临床效果

王凤1，邓伟芬1，王帅2 ，黎雪玲1，沈雷2

（1.深圳武警医院生殖中心，深圳，518000；2.深圳市第一人民医院妇科，深圳，518000）

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摘要：

目的 探讨无水酒精固化卵巢巧克力囊肿联合改良超长方案用于子宫内膜异位症的临床效果，以期提高患者的妊娠率。 方法 选择2014年4月至2015年12月于本中心行辅助生殖技术助孕的卵巢子宫内膜异位症患者326例为研究对象。所有患者均采用改良超长方案，其中联合采用无水酒精固化卵巢巧克力囊肿的108例子宫内膜异位症患者为研究组，同期仅行 单纯卵巢巧克力囊肿穿刺的子宫内膜异位症患者218例为对照组。比较两组患者的手术情况、复发情况及辅助生殖技术助孕结局。结果 研究组患者的手术时间明显长于对照组，二次抽吸囊肿率明显高于对照组，卵巢巧克力囊肿复发率明显低于对照组，差异均具有统计学意义（P<0.05）。两组患者的术中出血量、术中疼痛明显发生率及并发症发生率比较，差异无统计学意义（P>0.05）。研究组患者的MII 率、卵裂率、新鲜周期移植率及新鲜周期临床妊娠率明显高于对照组患者，差异均有统计学意义（P<0.05）；两组患者的Gn 用量、Gn 天数、HCG+LH、HCG+E2、HCG+P、获卵数、2PN 率、优质胚胎率、新鲜周期移植胚胎数、新鲜周期着床率、新鲜周期流产率、新鲜周期异位妊娠率、新鲜周期多胎率、冷冻周期移植胚胎数、冷冻周期临床妊娠率、冷冻周期流产率、冷冻周期异位妊娠率及冷冻周期多胎率比较，差异无统计学意义（P>0.05）。结论 无水酒精固化卵巢巧克力囊肿联合改良超长方案用于子宫内膜异位症辅助生殖技术助孕的患者可降低卵巢巧克力囊肿的复发率，提高临床妊娠率，大部分患者能新鲜周期移植，且操作简单可行，并发症少、患者痛苦不明显、费用低，值得临床推广应用。

关键词：无水酒精；卵巢巧克力囊肿；改良超长方案

中图分类号：R711.71；R714.8文献标志码：A文章编号：2096-1413(2017)19-0001-04

Clinical effect of absolute alcohol solidification in ovarian chocolate cyst combined with modified supper long protocol in patients with endometriosis
WANG Feng 1, DENG Wei-fen 1, WANG Shuai 2, LI Xue-ling 1, SHEN Lei 2
(1. Reproductive Center, Shenzhen Armed Police Hospital, Shenzhen 518000; 2. Department of Gynaecology and Obstetics, the first People``s Hospital of Shenzhen, Shenzhen 518000, China)


ABSTRACT: Objective To investigate the clinical effect of absolute alcohol solidification in ovarian chocolate cyst combined with modified supper long protocol in patients with endometriosis, for raising the pregnancy rate of the patients. Methods From April 2014 to December 2015, 326 endometriosis patients who received assisted reproductive technology in our center were selected as the study objects. All the patients were given modified supper long protocol, and 108 endometriosis patients who received absolute alcohol solidification in endometriotic cyst were chosen as the study group, and 218 endometriosis patients who accepted only ovarian chocolate cyst centesis were chosen as the control group. The operation situation, reccurence and assisted reproductive technology outcomes of the two groups were compared. Results The operation time of the study group was longer than that of the control group, the incidence rate of cystis secondary aspiration was higher than that of the control group, and the reccurence rate of ovarian chocolate cyst was lower than that of the control group (P<0.05). There was no significant difference in introperative blood loss, incidence rate of obvious pain and complications between the two groups (P>0.05). The MII rate, cleavage rate, fresh cycle transplantation rate and fresh cycle clinical pregnancy rate of the study group were higher than those of the contol group (P<0.05). There was no significant difference in dosage of Gn, days of Gn, HCG+LH, HCG+E2, HCG+P, numbers of retrieved oocytes, 2PN rate, high quality embryo rate, number of fresh cycle embryo transplantation, fresh cycle implantation rate, fresh cycle abortion rate, fresh cycle ectopic pregnancy rate, fresh cycle multiple birth rate, number of freezing cycle embryo transplantation, freezing cycle clinical pregnancy rate, freezing cycle abortion rate, freezing cycle ectopic pregnancy rate and freezing cycle multiple birth rate between the two groups (P>0.05). Conclusion Absolute alcohol solidification in ovarian chocolate cyst combined with modified supper long protocol in patients with endometriosis can reduce the reccurence rate of ovarian chocolate cyst and improve the clinical pregnancy rate, most of the patients can achieve fresh cycle transplantation. It has the advantages of simple and feasible operation, less complications, less pain and lower cost, which is worthy of clinical application and popularization.
KEYWORDS: alcohol solidification; ovarian chocolate cyst; modified supper long protoco

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